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Biomedical subjects

Warwick Middleton

Publications and source records attributed to Warwick Middleton.

10 recordsLinked to original sources
PubMed2006

The RANZCP Australian Private Practitioners' Network.

OBJECTIVE: To provide an overview of the challenges and opportunities afforded by the practice of psychiatry in the private sector, and in so doing build a rationale for the formation of a formally established network of Australian psychiatrists who meet to advance constructive proposals concerning the private practice of psychiatry, encourage mutual support, and promote this area of psychiatric endeavour. CONCLUSIONS: Private psychiatry has dangers, challenges and many responsibilities, but it also has the potential for relative independence and creative fulfilment. It is desirable that its practitioners support each other and work constructively together in addressing the sorts of issues delineated in the Private Practitioners' Network's mission statement and objectives.

Australia↗
PubMed2005

The effect of emotional context on cognitive inhibition and attentional processing in dissociative identity disorder.

In light of previous research, the current study tested the hypothesis that dissociative identity disorder (DID) would be characterised by effective cognitive inhibitory functioning when tested in a neutral context, but weakened inhibition when tested in an emotionally negative context. Using a negative priming task (i.e. the flanker task) to assess inhibitory ability 11 DID, 11 depressed, and 11 general population participants were tested in the two differing experimental contexts. The contexts were manipulated by instructions and word stimuli, and following the completion of this task participants completed the Dissociative Experiences Scale and the Schizotypal Personality Scale. DID participants displayed a greater degree of self-reported anxiety in the negative context and as expected displayed a reduction in inhibition in this context but not in the neutral context. The degree of negative priming for the depressed and general population samples remained stable across contexts as did their anxiety levels. The DID sample displayed slower response times to negative compared to neutral words but this attentional bias was not evident for the two comparison groups. The relationship between increased arousal, inhibitory functioning, dissociation and information processing in DID is discussed.

Adult↗
PubMed2005

Owning the past, claiming the present: perspectives on the treatment of dissociative patients.

OBJECTIVE: From the early 1990s there has been a growing awareness in Australia of dissociative processes and dissociative disorders. The objective in this paper is to provide a selective overview of the context and process of treatment based on the substantive dissociative disorders literature, ongoing clinical experience and research, and over 8 years as director of a trauma and dissociation unit at Belmont Hospital, Brisbane. CONCLUSIONS: The construct of individual selfhood is of direct relevance in illustrating the psychological damage sustained by patients who have relied on dissociative defences to survive, and in highlighting issues and areas that are a particular focus of informed treatment.

Adult↗
PubMed2005

Remembering the past, anticipating a future.

OBJECTIVE: To provide an overview of the phenomena of recovered memories and false memories of past traumas and to provide illustrations with clinical vignettes as well as historical observations. CONCLUSIONS: The questions concerning the recovery of memories of trauma do not readily reduce to simple dichotomies. Whatever the terminology applied, be it repression, dissociation or forgetting, humans have a capacity to not consciously know about aspects of their traumas for extended periods of time. The nature of memory is reconstructive. Memory is not a digital recording that provides for a totally accurate replay. Multiple factors including the age at which traumas occurred, the relationships to the person responsible or the nature and extent of the traumas influence what will be accessible to memory. In regard to those patients who describe recovered memories, it is important that clinicians take an individualistic approach and remain open-minded. They should not feel pressure to validate or reject the claim; rather, they should respect and empower patients.

Age Factors↗
PubMed2004

Dissociative disorders: a personal 'work in progress'.

OBJECTIVE: To identify the core issues contained within the dissociative disorders literature, and synthesize them into a non-polarized, inclusive perspective that emphasizes logic, core psychological principles and mutual professional respect. CONCLUSIONS: A large percentage of all psychiatric patients are traumatized in clinically significant manners. Dissociation, in all its variants, represents a psychological mechanism for the victim of trauma to defend him/herself from being overwhelmed. Debates regarding the validity of dissociative disorders need to be viewed in the context of society's counter-transference to trauma, in the context of health professionals feeling vulnerable to controversy, and in terms of their own experience of trauma.

Congresses as Topic↗
PubMed2004

Anna O and Hanna Q.

OBJECTIVE: To review the case of Anna O in light of perspectives offered by Dr Kaplan in his paper 'O Anna: being Bertha Pappenheim--historiography and biography' and to compare it with a contemporary case, that of Hanna Q. CONCLUSIONS: Josef Breuer's initial diagnoses do not need revision. However, the aetiology of such diagnoses is informed by subsequent research and by comparison with contemporary cases that can quite closely resemble that of Anna O's. Her symptomatology was not unique.

Adult↗
PubMed2004

Establishing and running a trauma and dissociation unit: a contemporary experience.

OBJECTIVE: To evaluate the functioning of a trauma and dissociation unit that has run for the past 8 years in a private hospital, with particular regard to operating philosophy, operating parameters, challenges encountered, research and educational initiatives, and the applicability of the treatment model to other settings. CONCLUSIONS: Despite the challenges associated with significant difficulties in the corporate management of a private health-care system, it has been possible to operate an inpatient and day hospital programme tailored to the needs of patients in the dissociative spectrum, and the lessons learnt from this experience are valid considerations in the future planning of mental health services overall.

Cooperative Behavior↗
PubMedDate not supplied

Assessing markers of working memory function in dissociative identity disorder using neutral stimuli: a comparison with clinical and general population samples.

OBJECTIVES: Memory functioning is a central conceptual and phenomenological aspect of dissociative identity disorder (DID). Most empirical work on memory functions in DID has focused on retrieval deficits either within or between dissociated identities. The current study attempted to remedy the scant attention given to working memory functioning. METHOD: In samples representing the DID, non-clinical, depressed, posttraumatic stress disorder (PTSD) and psychosis populations (n = 10 per group), neutral stimuli were used to examine three markers of working memory functioning: one measuring inhibition; one assessing facilitation; and one measuring interference. RESULTS: With the exception of the psychosis sample all groups displayed significant negative priming in the distractor inhibition condition. Facilitation effects were demonstrated by the DID and PTSD groups only. Interference effects were evident in all samples, though the DID and non-clinical groups demonstrated significantly more interference than the psychosis cohort. Distractor inhibition was related to overall schizotypy scores, and dissociation was related to scores in the facilitation condition. CONCLUSIONS: The DID sample displayed a completely distinct functional working memory profile to the psychosis sample when assessed with emotionally neutral stimuli. However, the working memory profile in the DID sample was not entirely dissimilar to the other comparison groups.

Adolescent↗